SCI

10 October 2024

Breast cancer statistics 2024

(CA Cancer J Clin. IF: 503.1)

  • Angela N. Giaquinto, Hyuna Sung, Lisa A. Newman, Rachel A. Freedman, Robert A. Smith, Jessica Star, Ahmedin Jemal, Rebecca L. Siegel

  • CORRESPONDENCE TO: angela.giaquinto@cancer.org

Abstract 摘要

This is the American Cancer Society's biennial update of statistics on breast cancer among women based on high‐quality incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Breast cancer incidence continued an upward trend, rising by 1% annually during 2012–2021, largely confined to localized‐stage and hormone receptor‐positive disease. A steeper increase in women younger than 50 years (1.4% annually) versus 50 years and older (0.7%) overall was only significant among White women. Asian American/Pacific Islander women had the fastest increase in both age groups (2.7% and 2.5% per year, respectively); consequently, young Asian American/Pacific Islander women had the second lowest rate in 2000 (57.4 per 100,000) but the highest rate in 2021 (86.3 per 100,000) alongside White women (86.4 per 100,000), surpassing Black women (81.5 per 100,000). In contrast, the overall breast cancer death rate continuously declined during 1989–2022 by 44% overall, translating to 517,900 fewer breast cancer deaths during this time. However, not all women have experienced this progress; mortality remained unchanged since 1990 in American Indian/Alaska Native women, and Black women have 38% higher mortality than White women despite 5% lower incidence. Although the Black‐White disparity partly reflects more triple‐negative cancers, Black women have the lowest survival for every breast cancer subtype and stage except localized disease, with which they are 10% less likely to be diagnosed than White women (58% vs. 68%), highlighting disadvantages in social determinants of health. Progress against breast cancer could be accelerated by mitigating racial, ethnic, and social disparities through improved clinical trial representation and access to high‐quality screening and treatment.

美国癌症协会根据国家癌症研究所和疾病控制与预防中心高质量的发病率和死亡率数据,每两年更新一次女性乳腺癌统计数据。乳腺癌的发病率继续呈上升趋势,在2012-2021年期间每年上升1%,乳腺癌发病率的上升主要局限于局部疾病发病上升和激素受体阳性乳腺癌发病率上升。总体而言,50岁以下女性(每年1.4%)比50岁及以上女性(0.7%)的乳腺癌比率的增幅更大,但这仅在白人女性中显著。亚裔美国人/太平洋岛民妇女在这两个年龄组中乳腺癌发病率增长最快(分别为每年2.7%和2.5%);年轻的亚裔美国人/太平洋岛民女性在2000年的乳腺癌发病率是第二低的(57.4/100000),但在2021年的比率最高(86.3/100000),与白人女性(86.4/100000)并列,超过了黑人女性(81.5/100000)。相比之下,1989年至2022年期间,乳腺癌总体死亡率持续下降44%,这意味着在此期间乳腺癌死亡人数减少了517900人。然而,并非所有女性都经历过这种进步;自1990年以来,美洲印第安人/阿拉斯加原住民妇女的乳腺癌死亡率保持不变,尽管黑人妇女的发病率低5%,黑人妇女的死亡率比白人妇女高38%。尽管黑人和白人的差异部分表现为更多的三阴性乳腺癌,但除了局部疾病外,黑人女性在所有乳腺癌亚型和阶段的存活率最低,她们被诊断为乳腺癌的可能性比白人女性低10%(58%对68%),这突出了在健康方面,社会决定因素带来的劣势。通过改善临床试验代表性和获得高质量筛查和治疗的机会,缓解种族、民族和社会差异,可以加速抗乳腺癌治疗的进展。

 

AI全文解析
这篇文章重点分析了美国乳腺癌的发病率和死亡率趋势,并深入探讨了种族、年龄、分子亚型等因素对乳腺癌的影响。以下是主要内容总结:

 

1. 发病率和趋势:美国乳腺癌发病率从2012年至2021年以每年1%的速度上升,特别是在年轻女性中增幅更大。在此期间,亚裔美国女性的发病率上升最快,尤其是在20至49岁和50岁以上年龄段。此外,乳腺癌的发病率因分子亚型而异,其中荷尔蒙受体阳性、HER2阴性亚型发病率最高。

 

2. 死亡率和生存率:乳腺癌死亡率自1989年以来下降了44%,这主要归功于早期检测和治疗的进步。然而,不同种族的死亡率存在显著差异,例如,黑人女性的乳腺癌死亡率比白人女性高38%,尽管其发病率较低。这种差距反映了种族间在健康社会决定因素和获得优质医疗服务方面的不平等。

 

3. 种族和年龄差异:黑人女性更易于确诊为三阴性乳腺癌(HR阴性、HER2阴性),这类癌症治疗选择较少,且预后较差。与此同时,乳腺癌生存率也因种族和分子亚型而显著不同,五年生存率在各亚型中差异明显。

 

4. 筛查和健康不平等:尽管乳腺癌筛查的普及率有所提高,但由于COVID-19疫情的影响,筛查率有所下降,特别是在少数族裔中。黑人女性报告的筛查率虽然较高,但往往在资源较少的设施中进行筛查,并在异常结果的随访中存在延误,这加剧了疾病晚期确诊的风险。

 

5. 改善乳腺癌结局的建议:作者建议,通过改善临床试验的代表性和增加对高质量筛查和治疗的获取途径,可以缩小种族、民族和社会经济方面的不平等,从而加速对乳腺癌的进展。

 

这篇文章呼吁关注乳腺癌在不同群体间的差异,并强调通过政策和医疗服务的改善来减少乳腺癌相关的健康差距